If your first reaction to January’s Correct Coding Initiative (CCI) edits bundling catheter ablations with electrophysiology (EP) studies was, “This has got to be a mistake!” you were right. You can expect the edits to be retroactively deleted in the quarterly update to CCI edits, version 16.1.
Bungled Bundle
According to a Coding News report, CCI version 16.0 bundles the following with atrioventricular (AV) ablation code 93650:
- Recording codes 93602 and 93603
- Pacing codes 93610, 93612, 93618, and 93623
- EP Study codes 93619, 93620-93622
You’ll also find pacing codes 93610 and 93612 bundled with supraventricular tachycardia (SVT) ablation code 93651; and ventricular tachycardia (VT) ablation code 93652 bundled with the following:
- Bundle of His recording code 93600
- Recording codes 93602 and 93603
- Pacing codes 93610, 93612 nd 93618
These code pair edits were assigned a modifier indicator of “0,” according to a Heart Rhythm Society report, meaning they cannot be overridden.
Interim Solution
Until version 16.1 edits go into effect, you have two choices for how to handle claims. The Centers for Medicare & Medicaid Services (CMS) suggests that you delay submission of claims that include the bundled code pairs until after version 16.1 goes into effect. Can’t afford the loss of quarterly revenue? Alternatively, you can submit claims as usual and then resubmit claims for denied services after April 1 when the retroactive deletion will appear in the claims processing contractor CCI files.
Resource: Download the latest CCI edits from the CMS website.